A pre-procedural 12-lead ECG schematic for accessory pathway localization in typical Wolff-Parkinson-White syndrome achieved 92.7% diagnostic accuracy and was associated with reduced total procedure duration and fluoroscopy exposure compared to a historical control cohort, while maintaining 100% acute procedural success and a favorable safety profile.
The novel stepwise 12-lead ECG schematic correctly predicted the accessory pathway anatomical zone in 92.7% of cases.
The acute procedural success rate for radiofrequency catheter ablation was 100% across all 109 patients.
Implementation of the ECG schematic was associated with a statistically significant reduction in total procedure duration compared to the historical control cohort.
Implementation of the ECG schematic was associated with a statistically significant reduction in fluoroscopy exposure time compared to the historical control cohort.
Right-sided accessory pathway ablations required significantly longer procedure durations and more radiofrequency energy delivery than left-sided ablations.
The procedure demonstrated a favorable safety profile with no major adverse cardiovascular events or permanent atrioventricular blocks.
This research suggests that using a structured, stepwise analysis of a standard 12-lead electrocardiogram (ECG) before a heart ablation procedure can reliably predict where an abnormal electrical pathway is located in patients with Wolff-Parkinson-White (WPW) syndrome — a condition where an extra electrical connection in the heart can cause dangerous rapid heart rhythms. In a study of 109 Vietnamese patients, the algorithm correctly identified the location of the abnormal pathway about 93% of the time, and every patient's procedure was ultimately successful in eliminating the pathway. Compared to a historical group of 189 patients treated without this pre-planning tool, using the ECG schematic was associated with shorter procedure times (about 6 minutes less on average) and meaningfully less radiation exposure from fluoroscopy (X-ray guidance used during the procedure). Right-sided abnormal pathways were consistently harder to ablate than left-sided ones, requiring more radiofrequency energy applications and longer procedure times, though radiation exposure was similar between the two sides. This research suggests that incorporating a systematic ECG-based localization algorithm before catheter ablation for WPW syndrome can make procedures more efficient and reduce radiation exposure for both patients and medical staff, without compromising safety or success rates. The single complication — a brief, self-resolving nerve response in one patient — underscores the generally low-risk nature of the procedure when performed with thorough pre-procedural planning.
Chu S, Tran M. (2026). Impact of a Novel Pre-Procedural ECG Schematic for Accessory Pathway Localization on Procedural Outcomes of Radiofrequency Catheter Ablation in Typical Wolff-Parkinson-White Syndrome.. Cellular physiology and biochemistry : international journal of experimental cellular physiology, biochemistry, and pharmacology. https://doi.org/10.33594/000000888